The man was pale and clammy. He felt as if a weight was pressing on his chest and grimaced in pain – a look that makes everyone in the ER scramble without even being told. He was young, not even 30, but within minutes, the EKG I had ordered was done and blood tests were sent. We gave him nitroglycerin and morphine. He felt better, but was still drenched in sweat and looked weak.
The EKG looked good. In fact, it was totally normal. Then the blood tests came back: no heart damage.
What was the problem? He had just started his own business. Things hadn’t been going well: He hadn’t slept in days, was making no money, and lived off Red Bulls and coffee. Although he was only 30 and had never had any health problems, the burden of trying to get a new business off the ground had become too much.
There’s plenty of stress to go around these days. As a doctor, I’ve seen how a fight with your husband or your boss, or losing a job can send people to the emergency room. But now studies have shown a clear link between stress and heart attacks as well.
A recent study called INTERHEART, published in the Lancet medical journal, collected information on thousands of heart attack patients in over 50 countries around the world. Researchers wanted to identify the most important risk factors that could predict a heart attack, and it was unique in its international scope. The usual risk factors were all present: high cholesterol, smoking, obesity, diabetes and high blood pressure were the major factors linked to heart attacks.
But one of the most interesting findings was that patients who reported high stress levels also had a higher risk of heart attack, even when the other factors were taken into account. The importance of stress was consistent across-the-board, in people from Africa, Europe, Asia and the United States, and seemed to be as important as high blood pressure.
So stress isn’t just a homegrown phenomenon. Other studies have shown that workplace and marital stress have been linked to heart attacks. In these down times, how can you control stress as a risk factor?
The first step is to know where your stress comes from. Is it family, financial, or work-related? A man once came to my office complaining of chest pains. He was young, used to work out, but then told me that he recently moved out of San Francisco. He still worked in the city, but now had a one hour commute each way. He hated every minute of it. In addition, he had stopped exercising because the commute time had taken over his workout sessions.
What’s the solution? After a full cardiac evaluation that showed his heart was healthy, I told him to make time for exercise again and learn to live with the commute stress.
He decided that he couldn’t quit his job, so we talked about ways to deal with his commute. He started exercising again, lost weight - and the chest pains disappeared. He doesn’t love his commute any more than in the past. But he had identified his stress, accepted it as something unavoidable and learned to control it.
And that is the most important aspect about treating stress. Although much of our stress cannot be eliminated, it can almost always be managed.
Find the stressors in your own life—are you dealing with them in the best way? Is the stress avoidable? If not, sometimes a different approach, like dividing a large job into smaller ones, can help the stress melt away. Focusing on these tactics can help you feel more in control and skip a trip to the emergency room.